044044   FERNANDES L , JADHAV A R, KARNIK P, RODRIGUES B, ANANTHASUBRAMANIAN D, KOLI A (Pediatrics Dep, Municipal Medical Coll and General Hospital, Mumbai, Maharashtra, Email: lavinaa.fernandes@gmail.com) : Assessing the efficacy of low cost indigenously produced soya based ready to use therapeutic food with standard indigenously produced peanut based ready to use therapeutic food. Int J Med Res Health Sci 2020, 9(12), 116-23.

Ready-to-Use Therapeutic Food (RUTF) is considered a gold standard in management of Severely Acute Malnourished (SAM) children. Its use is limited in resource poor settings due to cost constraint. We prepared Soya based RUTF costing 25 % less using WHO recommendations. Objective: To compare efficacy between soya based RUTF named as Soya-Medical Nutrition Therapy (S-MNT) and standard Peanut based RUTF named as Peanut-Medical Nutrition Therapy (P-MNT) in treatment of SAM. Methods: This open randomized controlled trial enrolled children between (6-60) months, diagnosed as SAM by WHO criteria. Subjects were divided into two groups that received S-MNT or P-MNT for 12 weeks. Main outcome measures were rate of weight gain (g/kg/day) and change in nutritional status.Result: Of 125 SAM children enrolled, 78 completed 12 weeks of intervention. At week 2, rate of weight gain in P-MNT was 2.8 g/kg/day and S-MNT was 2.43 g/kg/day (p=0.662). At 12 weeks, it was 0.75 g/kg/day in PMNT and 0.87 g/kg/day in S-MNT (p=0.821). The mean rate of weight gain in P-MNT group was 2.49 g/kg/day while in S-MNT group was 1.78 g/kg/day which were statistically not significant. 75 % subjects recovered from SAM in S-MNT while 89.13 % in P-MNT (p=0.496). Pre and Post mean weight in both the groups were significant (p<0.001). 25 % subjects had less than 30 % consumption of S-MNT compared to 13.04 % in P-MNT group. Conclusion: S-MNT was found to be as efficacious as P-MNT and hence can be a good alternative in SAM management. Soya based RUTF reduces cost of therapy without compromising the nutritional quality of RUTF

3 illus, 3 tables, 22 ref

044043   GAUR V, CHAUDHARY S , AGARWAL S, SHARAWAT S K , BAKHSHI S, SHARMA P , KUMAR S (Amity Univ, Uttar Pradesh, Noida, Email: psharma8@amity.edu) : miR-4772-5p and miR-196b as potential prognostic biomarker in pediatric core binding factor acute myeloid leukemia. Int J Med Res Health Sci 2020, 9(12), 104-15.

Aberrant expression of miRNAs has been linked with the initiation and progression of several cancers. However, their role as prognostic biomarkers in pediatric core binding factor AML (CBF-AML) is still unclear. The objective of the present study was to identify differentially expressed miRNAs and their prognostic significance in pediatric CBF-AML patients. Bone marrow samples from 28 pediatric CBF-AML patients and 27 pediatric controls were obtained after ethical approval. Based on our previous findings, expression levels of 11 miRNAs and their selected potential targets were analysed using TaqMan advanced miRNA assay and SYBR Green-based qRTPCR, respectively. Differential miRNA expression was correlated with clinicopathological parameters and survival outcomes. Upregulation of miR-100-5p, miR-4446-3p, and miR-335-3p and downregulation of miR-409-3p, miR-151a-3p, miR-196b, miR-4772-5p, and miR-758-3p was observed in pediatric CBF-AML patients as compared to controls. Low miR-196b expression was associated with poor disease-free and overall survival and low expression of miR-4772-5p was found to be an independent predictor of poor event-free survival. Except PAX-5, other predicted gene targets were found to be upregulated in pediatric CBF-AML patients. miR-196b and miR-4772-5p may be considered as independent prognostic biomarkers in pediatric CBF-AML. The miRNA-mRNA interaction network suggests potential involvement of miRNAs, which needs to be further confirmed using mechanistic studies.

4 illus, 4 tables, 41 ref

044042   AL-GETHAMY M M , ADETUNJI H A, HAFEEZ Z , AL-QATABI D , ABBAS S, KARAR H , MERWASS N A (Public Health and Health Informatics Dep, Umm Al Qura Univ, Makkah, KSA, Email: hamed.tunji@gmail.com) : A prospective study of epidemiology of central line associated bloodstream infections at atertiary hospital Makkah Saudi Arabia. Int J Med Res Health Sci 2020, 9(12), 98-103.

The epidemiology of central line-associated bloodstream infections in Al Noor Hospital Specialist Hospital has not previously been reported. We sought to describe time-trends in central line-associated bloodstream infections rates, etiology, and responsible pathogens for the period January 1, 2016-December 31, 2018. Materials and Methods: All 120 patients age 18 years and older admitted to all departments of a Tertiary Hospital who had double lumen catheters inserted during the study period were followed up and monitored for central line-associated bloodstream infections. From 120 patients who had a central venous catheter inserted, 20 developed blood infections. The catheterization duration was significantly longer with approximately 11 days among the infected against 6 days in non-infected. The most frequently isolated organism was Klebsiella pneumonieae. The infection rate recorded were 30.67, 23.06, and 16.39 per 1000 catheter days in 2016, 2017, and 2018 respectively. The overall rate for the 2 years of study was 24.06 per 1000 catheter days. Keeping the catheter beyond the period required increases infection rate while avoiding femoral catheter site insertion leads to reduction. If the Line Care Protocol of best practices and education of staff regarding the protocol are implemented infection rates will reduce.

3 tables, 25 ref

044041   RAJ R V, ANITHA TS , PAJANIVEL R , KUDUVALLI S S , ADITHAN C (Pulmonary Medicine Dep, Mahatma Gandhi Medical Coll and Research Institute, Sri Balaji Vidyapeeth, Puducherry, Email: iniyaulagam@ymail.com) : Correlation of sputum mir-144 copy levels with treatment response among pulmonary tuberculosis patients. Int J Med Res Health Sci 2020, 9(12), 89-97.

MicroRNAs are approximately 22 nucleotides (nt) in length, small non-coding RNAs (ncRNAs), playing a vital role during post-transcriptional regulation of mycobacterial infection. Few sputum microRNAs (sputum miR) were evaluated in literature for their role as potential biomarkers in diagnosing Pulmonary Tuberculosis (PTB), but the correlation with a full course of Tuberculosis (TB) treatment is yet to be ascertained. Sputum samples of forty-six PTB patients were collected for Acid Fast Bacilli (AFB) staining and sputum microRNA-144 (sputum miR144) copy analysis, before, during, and at the end of treatment as per Indian National guidelines. Twelve patients of Asthma or Chronic Obstructive Pulmonary Disease (COPD), not in infective exacerbation, were recruited as controls. Sputum miR-144 copy levels were measured by quantitative Real-Time PCR (qRT-PCR) method. pThe difference between the baseline sputum miR-144 copy levels of patients and that of controls was found to be significantly higher (p <0.001). Significant up-regulation of sputum miR-144 copy levels at the baseline, as compared to controls, and significant downregulation during and after the full course of treatment was noted (all p <0.001). The potential role of sputum miR-144 as a simple and non-invasive surrogate biomarker in the diagnosis and treatment of PTB gains importances.

3 illus, 2 tables, 38 ref

044039   SALAMA R A A (Community Medicine Dep, Ras Al Khaimah Medical and Health Science Univ, Egypt, Email: rasha.aziz@rakmhsu.ac.ae) : Review of implementation, barriers and challenges of premarital care program in the middle east countries. Int J Med Res Health Sci 2020, 9(12), 69-78.

Many governments especially in the Middle East countries have been promoting premarital medical examinations since the first half of the 20^th century. However, the prevalence of inherited disorders and consanguinity remains high Objectives: To explore the process of implementation of premarital care programs and highlight the possible barriers and challenges to program effectiveness in the Middle East countries. Recommendations to add momentum to current health care efforts were also outlined. Relevant works of literature were retrieved from different journals and web pages. The electronic databases were searched using the key. The review included both Arabic and English literature related to the premarital care program. A review of the effectiveness of premarital screening programs in the Middle East countries indicated that the program did not achieve the stated objectives in discouraging at-risk marriages and lowering genetic disease prevalence except in some countries providing prenatal detection and therapeutic abortion. Scarcity of resources, lack of trained health professionals, lax enforcement of PMS laws, and high prevalence of consanguineous marriage were the major barriers to the successful implementation of premarital screening programs in the Middle East. Knowledge about inherited genetic disorders and the outcome of the diseases is low. Screening timing, access to prenatal detection and abortion, religious beliefs, also have a role in the success of the program. Efforts should be directed to policy advocacy and public education strategies. A life cycle approach to prevention, incorporation of school screening, awareness campaigns, reconsideration of therapeutic abortion are likely to improve the effectiveness of such programs in the Middle Eastern region.

1 table, 62 ref

044038   FATHULDEEN A A, ALHARBI R M A , ALSHAGHDALI S F, ALRASHEED W S S , ALHAZIMI A A M , ALHARBI Z (Ha’il Univ, Ha’il, Saudi Arabia, Email: Salem.Alshaghdali@outlook.com) : The pyrosphere prosthesis compared with epping-arthroplasty for Surgical treatment of thumb root arthritis: a clinical cohort study. Int J Med Res Health Sci 2020, 9(12), 59-68.

Rhizarthrosis indicates osteoarthritis induced degenerative changes of the thumb root. Several surgical interventions have been previously described. Our question is whether the PyroSphere joint replacement shows superior results when compared to other operative techniques such as Epping-Plasty for the treatment of thumb root arthritis. Therefore, the purpose of this study was to compare the efficacy of both interventions. Methods: In this clinical cohort study we reviewed our medical database to identify patients who suffered from rhizarthrosis Grade II-III according to Eaton Littler, who were treated operatively between 2002 and 2018. After a mean follow-up of 13 years, 14 cases were evaluated. Evaluation by clinical examination includes range of motion of the thumb, Kapandji score, force measurement of the thumb and hand using JAMAR dynamometer for grip and pinch strength. Pain assessment was done; DASH-Score and DSG questionnaire were also performed. Results: 14 hands were included, The PyroSphere joint prosthetics were observed in 7 hands and the Epping-Plasty group included the other 7 hands. In all comparative tests, P values were not statistically significant (all p>0.05). Conclusion: This study concludes that PyroSphere prosthetics show no superior results when compared to Epping-arthroplasty for the treatment of thumb root arthritis.

7 illus, 3 tables, 47 ref

044037   ALRUWAYS M W, ELRAYAH I E, MANSI M A (Clinical Laboratories Dep, Shagra Univ, Saudi Arabia, Email: elreyagh@su.edu.sa) : Effect of benzoin resin fumes on indoor environmental microbes. Int J Med Res Health Sci 2020, 9(12), 52-8.

This work aimed to investigate the antimicrobial effect of traditional Saudi Arabian incense (white benzoin resin, Jawi) on indoor environment microbes in Shaqra University, Dawadmi Female Student Campus, and bacterial isolates from patients in Dawadmi General Hospital. The effect of white benzoin resin fumes was tested directly on clinical bacterial isolates. The bacterial culture plates were incubated with benzoin resin fumes within a confined space. The microbial quality of indoor air in four laboratories, lecture rooms, library, and restroom of the students was measured, and the effect of benzoin resin fumes on these indoor microbes was determined. The settle plate method with open Petri dishes containing different culture media was used to collect samples two times daily before and after benzoin resin fumes were used. The growth of Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans was completely inhibited after exposure to benzoin resin fumes for 90 min. The growth of Klebsiella pneumoniae, Escherichia coli, and Enterobacter aerogenes was inhibited by 79 %, 68 %, and 55 %, respectively, after the same incubation time. Fumigation of selected university premises with the incense decreased the total bacterial count from 23.5 Colony-Forming Units (CFU) to 6.25 CFU. The application of benzoin resin fumes in some university premises showed a promising effect on decreasing the total number of microorganisms in the air of some rooms and inhibiting the growth of some pathogenic bacteria.

3 illus, 26 ref

044036   DUARSA A B S, ARJITA I P D (Al Azhar Islamic Univ of Mataram, West Nusa Tenggara, Indonesia, Email: duarsaartha@gmail.com) : Model modification of participatory of community asset development research in action (yudhia) for childbirth and pregnancy. Int J Med Res Health Sci 2020, 9(12), 33-51.

Direct maternal deaths are mostly caused by obstetric complications. Several programs have been carried out to reduce the incidence of pregnancy and childbirth complications. However, the implementation of the program has not been maximized. Community empowerment is needed to ensure the sustainability of the program. Therefore this study was carried out for Model Modification of Participatory Community Asset Development Research in Action (YUDHIA). This research was conducted with a mixed-method approach. The construction model was carried out qualitatively, with forum group discussion and in-depth interview toward four key informants and thirteen supporting informants. Then conducting model development quantitatively using a cross-sectional study on 80 respondents, and analyzed by using SEM PLS. After the model was formed, the test was implemented to 83 respondents by using pre and post-test design. The application of the YUDHIA Model in the community is carried out by assisting the model using the YUDHIA Module. The construction shows that the YUDHIA Model can be constructed by five variables, namely the development of community assets, community participation, knowledge, attitudes, and behavior. Then the validation is done and the results are obtained that all the variables are valid in forming the YUDHIA Model. The YUDHIA assistance model is statistically proven to be able to improve knowledge (p 0.000), attitudes (p 0.000) and behavior of the pregnant mothers (p 0.000) compared to before getting assistance.The YUDHIA model consists of five forming variables and this model has proven effective in increasing the knowledge, attitudes, and behavior of pregnant mothers towards the prevention of pregnancy and childbirth complications.

8 illus, 12 tables, 44 ref

044035   DANIEL S, NANDAKUMAR G, NAIR K G B, SADASIVAN S (Pathology Dep, Government Medical Coll, Trivandrum, Kerala, Email: sherin1607@gmail.com) : Clinicopathological study of vesiculobullous diseases with special emphasis on autoimmune disorders-two year study in a resource setting. Int J Med Res Health Sci 2020, 9(12), 14-32.

To identify the characteristic histopathologic findings and analyse the diagnostic concordance between clinical and histopathological diagnosis of patients with vesiculobullous diseases. Methods: This was a two-year descriptive study conducted in the Department of Pathology where all skin biopsies diagnosed as vesiculobullous diseases were included. A detailed history and relevant clinical examination findings were documented. The specimens were formalin-fixed, paraffin-embedded and stained with haematoxylin and eosin. Direct immunofluorescence was advised for patients where histopathologic features were inconclusive. Results: There were 111 skin biopsy specimens included in the study. Demographic details showed female predominance (65.8 %) and the most frequent age group being (40-69) years (29 %). Generalised distribution of the lesions over the trunk (53 %) associated with itching was the common clinical manifestation. Most frequent clinical diagnosis in the study was pemphigus vulgaris (38 %) and bullous pemphigoid (31 %). Histopathologic findings revealed subepidermal blister (52.3 %) as the most common finding. Inflammatory cell infiltrates constituted the main content of the blister (44.1 %) with eosinophils being the predominant cell type (37.8 %). There was a good positive correlation of 0.546 between histopathologic and clinical diagnosis. Conclusion: Bullous pemphigoid constituted the most common vesiculobullous disease followed by pemphigus vulgaris in this study. Histopathological diagnosis correlated well with clinical diagnosis in most of the vesiculobullous disease, emphasizing the need for skin biopsy in all cases of vesiculobullous diseases. Direct Immunofluorescence is a helpful adjunct in scenarios where clinical and/ or histopathological features are inconclusive.

18 illus, 9 tables, 19 ref

044034   AL-KAZWEENY R , MUHI-ELDEEN Z A , AL-KAISSI E, AL-TAMEEMI S , TAYEH S S , AL-HUSSENINI J (Pharmaceutics and Pharmaceutical Technology Dep, Petra Univ, Amman, Jordan, Email: ealkaissi@uop.edu.jo) : Designs, synthesis, structural elucidation and antimicrobial evaluation of various derivatives of 2-mercaptobenzimidazole as possible antimicrobial agents. Int J Med Res Health Sci 2020, 9(12), 1-13.

Derivatives of 2-Mercaptobenzimidazole (2-MBI) are very significant heterocyclic compounds. 2-MBI and its derivatives have been showing different biological activates, the most significant activity exhibiting the antimicrobial activity. The aim of the project includes the synthesis of new derivatives of 2-MBI. Methods: Formation of 2-(Phenethylthio)-1H-benzo[d] imidazole (ZR-1) by alkylation, thioester S-(1H-benzo[d]imidazol-2-yl) O-ethyl carbonothioate (ZRJ2), S-(1H-benzo[d]imidazol-2-yl) O-isobutyl carbonothioate (ZR-4), and S-(1H-benzo[d] imidazol-2-yl) O-methyl carbonothioate (ZR-8), the reaction involves thio acetic derivative 2-((1H-benzo[d]imidazol2-yl) thio) acetic acid (ZR-3) with oxalyl chloride to generate acyl derivatives to this added cyclic amines to yield compounds, amid derivatives 2-((1H-benzo[d]imidazol-2-yl) thio)-1-(2, 6-dimethylpiperidin-1-yl) ethan-1-one (ZR-5), 2-((1H-benzo[d]imidazol-2-yl) thio)-1-(pyrrolidin-1-yl) ethan-1-one (ZR-6), and 2-((1H-benzo[d]imidazol2-yl) thio)-1-(4-methylpiperazin-1-yl) ethan-1-one (ZR-7). Results: Structure of newly synthesized compounds have been verified through FT-IR, DSC, Elemental analysis, 1H-NMR, 13C-NMR, and Molecular docking, it indicates one of these compound (ZR-5) has great affinity (-8.70) than our stander (trimethoprim -7.91Kcal/ mol. into DHFR). An antimicrobial activity was evaluated by agar diffusion methods and broth dilution test against Staphylococcus aureus (ATCC 6538), Escherichia coli (ATCC 8739), Pseudomonas aeruginosa (ATCC 9027), Bacillus subtilis (ATCC 6633) and Candida albicans (ATCC 10231). The Minimum Inhibitory Concentrations (MIC) and the Minimum Bactericidal Concentration (MBC) were determined and compared with ciprofloxacin (85.51 %), trimethoprim and fluconazole (99.9 %) as standard positive control drugs, Conclusion: Compound (ZR-8) showed excellent antifungal activity and good antibacterial activity compared to ciprofloxacin and trimethoprim. The results promoted the interest to do more structural modifications to enhance the antimicrobial activity and their antimicrobial selectivity

3 illus, 4 tables, 28 ref

044033   ALBISHI A M, ALSHAHRANI A , ALSHAHRANI A M , ALAHMARI D M , ALQIBTI H M, ALSHARIF M A , ALSHAHRANI S M , ALQAHTANI M S, ALQAHTANI I A S (Armed Forces Hospital, Khamis Mushayt, Saudi Arabia, Email: dr.abdullah6975@gmail.com) : Public awareness of hepatocellular carcinoma and its risk factors among general population in southern region, Saudi Arabia, cross sectional study. Int J Med Res Health Sci 2020, 9(11), 46-53.

Globally, Hepatocellular carcinoma (HCC) is the third leading cause of cancer related mortality. There are many reported causes of HCC including chronic Hepatitis B virus (HBV), Hepatitis C virus (HCV) infection, primary autoimmune hepatitis, hemochromatosis, Budd-Chiari syndrome, and chronic alcohol consumption, which mostly result in liver cirrhosis. Fibrosis and cirrhosis are typically antecedents of HCC. Lack of population awareness may be by itself risk factors for disease and its sequalae. To assess the general population awareness regarding hepatocellular carcinoma and its risk factors in Southern region, southern of Saudi Arabia. Methodology: A descriptive cross-sectional survey was used targeting all population in Southern region, Saudi Arabia. The study was conducted during the period from February 2020 to May 2020. Data were collected using structured questionnaire included person’s socio-demographic data, Participants’ awareness regarding HCC. The questionnaire was uploaded online using social media platforms. Results: The study included a total of 956 participants whose ages ranged from 18 to 65 years old with mean age of 31.5 ± 8.6 years old. Exact of 149 (15.6 %) participants had positive family history of liver cancer and 157 (16.4 %) had family history of liver cirrhosis. Exact of 78.7 % of the respondents reported that they know about liver cancer and 75.2 % know about liver cirrhosis. In total, good awareness level regarding liver cirrhosis and cancer was low. The study revealed that public awareness regarding HCC and its risk factors were low especially for signs and symptoms which are the early alarming noise for having liver disorder. Health care staff was not the main source of knowledge regarding HCC and liver cirrhosis.

1 illus, 4 tables, 20 ref

044032   AL-RADDADI H S, AL-DUBAI S A R (Family and Community Medicine Dep, Taibah Univ, Al Madinah, Saudi Arabia, Email: Huda.s.alradaay@hotmail.com) : Physical activity affects the sleep quality of women in Saudi Arabia: A prospective follow-up study. Int J Med Res Health Sci 2020, 9(11), 39-45.

The prevalence rates of sleep insufficiency and physical inactivity are increasing worldwide. Accumulating evidence indicates a relationship between physical inactivity and sleep disturbance. This study aimed to determine the impact of physical activity on sleep quality and body mass index in women in Saudi Arabia. This prospective study included 63 women at sport clubs in Medina, Kingdom of Saudi Arabia. The study was conducted between June 2019 and August 2019. All participants were followed up for 3 months. Sleep quality was measured using the validated Pittsburgh sleep quality index, and physical activity was measured using the validated international physical activity questionnaire. Sleep quality and body mass index were compared at baseline and after 3 months using paired t-tests. Results: Physical activity improved sleep quality (p=0.034) and reduced BMI (p=0.002) significantly. Physical activity improves sleep quality and decreases body mass index.

4 tables, 30 ref

044031   PINGUE-RAGUINI M , ABUJABER A , GOMMA N (Fakeeh College for Medical Sciences, Jeddah, Kingdom of Saudi Arabia, Email: mproguni@fcms.edu.sa) : Students’ level of satisfaction in nursing skills demonstration: Basis for designing debriefing strategies. Int J Med Res Health Sci 2020, 9(11), 30-8.

The use of laboratory in demonstrating nursing skills to enhance students competency will highly benefit in the transition of theory learned into the delivery of care to actual patients in the clinical field. It provides opportunities to practice the procedures, evaluate learning outcomes and reinforce reasoning objectives. Objective: The study aims to identify the level of satisfaction of nursing students in the skills demonstration in terms of debriefing and reflection, clinical reasoning and clinical learning. This study used the Quantitative-Descriptive design to describe the level of student satisfaction in nursing skills. The results of the study showed that the majority of FCMS nursing students expressed high level of satisfaction according to level of respondents. Mean=3.81). Meanwhile, FCMS nursing expressed a high level of satisfaction in three categories debrief and reflection (Mean=3.77; χ2 =90.796), clinical reasoning (Mean=3.80; χ2 =77. 632) and clinical learning (Mean=3.86; χ2 =93.285). The results highlighted that the nursing students mostly benefited from clinical learning during skills demonstration. Conclusion: The study concludes that the nursing students of FCMS have a high level of satisfaction in nursing skills demonstrations in terms of clinical learning and clinical reasoning.

1 illus, 7 tables, 20 ref

044030   ALQAHTANI N (Clinical Nutrition Dep, Northern Border Univ, Arar, Saudi Arabia, Email: nalqahtaniphd@gmail.com) : The effects of peer pressure on nutrition attitudes and food selection. Int J Med Res Health Sci 2020, 9(11), 23-30.

Considerable time is spent at work and unhealthy eating behaviors may be acquired through frequent pressure from co-workers. The consequences of such an attitude can be devastating to individuals’ health (via obesity) and to the workplace (via the costs of absenteeism). The aim of this study is to assess the impact (peer pressure) of co-workers on eating behaviors and food choices among Saudi employees. A cross-sectional study was conducted among employees working at multiple organizations in the Northern Regions of Saudi Arabia. A selfadministered questionnaire was submitted to a representative sample with different Body mass index (BMIs). The demographic data of the participants, the variables regarding meal consumption patterns at work, and data about the influence of peers on food choices were collected. A total of 937 employees responded (60.7 % females, 74 % overweight or obese). Most respondents would take meals with co-workers (84.3 %) and were influenced by co-workers in their food choices (61.2 %); these influences were negative (unhealthy food) for 29.9 %. Interestingly, co-workers hindered plans for healthy diets frequently or occasionally in 75.4 % of participants. Unlike those with low BMIs, a significant proportion of obese employees were influenced in their food choices by co-workers (p=0.004) in a negative way (p=0.012) and had their healthy diets disrupted by co-workers as well (p=0.004). Saudi employees are strongly influenced by peer pressure regarding food choices. Targeted intervention programs should be tailored to increase employees’ knowledge regarding healthy food choices, resisting the pressure of co-workers, and supporting self-efficacy in eating.

4 tables, 21 ref

044029   GUILLASPER J N , AQUINO M G B, SORIANO G P (Nueva Ecija Univ of Science and Technology, Nueva Ecija, Philippines, Email: gil.p.soriano@gmail.com) : Fatty acid concentration of farmed tilapia (Oreochromis niloticus) in selected sites in the Philippinesa. Int J Med Res Health Sci 2020, 9(11), 18-22.

Farm-raised tilapia contains very low levels of the beneficial very long-chain omega-3 fatty acid and very high levels of omega-6 fatty acid. Excessive amounts of omega-6 fatty acids and a very high omega-6/omega-3 ratio, promote the pathogenesis of many diseases, including cardiovascular disease, cancer, and inflammatory and autoimmune diseases, whereas increased levels of omega-3 PUFA (a low omega-6/omega-3 ratio) exert suppressive effects. Hence, the study determined the omega-3 and omega-6 fatty acid content of farmed tilapia and the omega-6/omega-3 ratio. Methods: Samples of farmed tilapia were taken from four sites namely: Batangas, Nueva Ecija, Pampanga and Isabela. The omega-3 and omega-6 fatty acid levels in farmed tilapia and the omega-6/ omega-3 ratio were analyzed using gas chromatography. Results: Tilapia from Isabela has the highest amount of fatty acids for both omega-6 (1.2 mg/100g) and omega-3 (EPA 1.5 mg/100 g; DHA 61.8 mg/100 g) respectively. On the other hand, tilapia from Batangas has the lowest amount of total fatty acids with omega-6 of 0.70 mg/100 g and omega-3 of EPA 4.2 mg/100 g and DHA 2.2 mg/100 g. For all the samples from each site, omega-3 has a higher amount of fatty acid compared to its omega-6 fatty acid while the omega-6 and omega-3 ratio in all the four sites was less than 1:1. Conclusion: The omega-3 (eicosapentaenoic acid and docosahexaenoic acid) fatty acid concentration of farmed tilapia taken from Isabela, Nueva Ecija, Pampanga and Batangas has higher concentration than omega-6 and the ratio between the two fatty acids met the values for the recommended ratio.

2 tables, 19 ref

044028   ALNAKHLI Z J, ALMUTARI S, AL-DUBAI S A R (Joint Program of Family Medicine Post Graduate Studies, Al-Madinah, Saudi Arabia, Email: Zainab.jameel1993@gmail.com) : Assessment of burden on caregivers of children with attention deficithyperactivity disorder in Al-Madinah, Saudi Arabia. Int J Med Res Health Sci 2020, 9(10), 10-7.

Caregivers of children experiencing mental health challenges reporting negative physical and emotional effects due to the lack of recognition and support. This study aimed to explore the burden on caregivers of children with Attention deficit hyperactivity disorder (ADHD) in Medina. A cross-sectional study was conducted in the child psychiatric, developmental and behavioural clinics at Maternity and the children hospital (MMCH) and child psychiatric clinic at AlAmal hospital for mental health in Medina among 80 caregivers. The validated Arabic version of ZBI scale was distributed to 80 participants. T test and ANOVA test were performed to assess the association between sociodemographic variables and ZBI scale.The age of participants ranged between 20 and 60 years. Females represent most of them (66.2 %). Moderate to severe and severe burden on caregivers of children with ADHD were observed among 43.8 % and 18.8 % of the participants, respectively. Gender of the caregivers was significantly associated with burden of care giving as score of ZBI was significantly higher in females compared to males (47.3 ± 16.5 versus 39.3 ± 16.8), p=0.045. Burden on caregivers of children with ADHD in Medina was very high prevalent, particularly among female caregivers.

5 tables, 27 ref

044027   MATHUR S, SINGH P (Nutrition and Dietetics Dep, MRIIRS, Haryana, Email: dtshashim@gmail.com) : Nutritional and non-nutritional parameters associated with chronic obstructive pulmonary disease (COPD): A review. Int J Med Res Health Sci 2020, 9(10), 55-61.

Chronic Obstructive Pulmonary Disease or COPD is the disease that effects the lungs where there is obstruction of the flow of air to the lungs hindering with the normal breathing. A lot of studies have been done, at the national and international level, on the factors associated with the causation and/or treatment of COPD, both nutritional and nonnutritional. In this paper both these aspects have been reviewed. Under the nutritional aspects the effects of high fibre intake and ω-3 fatty acids through dietary sources have been covered. Under non-nutritional aspects, factors covered are cigarette /tobacco smoking, ABH secretor status, age, gender, BMI, MUAC, family history (hereditary factors) and clinical history with special emphasis on childhood respiratory infections. Along with all the above factors, air-pollution is also one of the major concerns for lung health. The respiratory system is affected by air pollutants such as carbon monoxide, ozone, nitrogen dioxide, sulphur dioxide, and particulate matters with particle size 2.5 to 10. In these studies, clinical diagnosis of COPD, was based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD standard) or the COPD guidelines. The GOLD guidelines, advises spirometry as the gold standard as it is accurate and gives the measurement that are repeatable for the lung function. The cut-off according to GOLD criterion as FEV1/FVC should be between 0.6 to 0.8, where FEV1 and FCV are the lung function measurements and FEV1 is the forced expired volume in one second and FVC is the forced vital capacity.

28 ref

044026   IZZATOV A (Tyan Anmo Medical Massage School, Illinois, USA, Email: aybekizzatov@yahoo.com) : Effectiveness of physical and manual therapy and communication in children with attention deficit hyperactivity disorder: A randomized controlled trial. Int J Med Res Health Sci 2020, 9(11), 01-9.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder which mainly affects children. It affects their physical, mental, social, occupational and academic well-being. They show lack of attention and demonstrate hyperactivity, which affects their learning capability. They also have impaired language articulation which affects their communication capability. In the present study the sample consisted of two groups with a total of 5 children, as research participants. It was composed of the 1st control group: Three male children, aged between 4-12 years and the second, therapeutic group consisting of 2 male children, aged between 6-8 years. In the test (therapeutic group) the children were given a combination treatment consisting of verbal communication and physical therapy under the guidance of a practitioner. The children who belonged to the control group were given treatment consisting of only plain physical therapy as performed by the practitioner. In both the groups the sessions were performed 2 times a week for one hour extending up to 2 months. After the treatment, better outcome was seen in the test group. Their attention span increased to 2-3 times. They started making eye contact when the physical therapy was performed. Additionally, when the therapist was communicating with them they started obeying his commands and also improved cooperating with their parents. On the other hand, in the control group, there were not much behavioral changes noticed. The study shows that verbal communication plays an important role to bring out a positive behavior and increase attention span in children with ADHD.

69 ref

044025   MJALI A, MATTI B F, KAREEM Y A A , HASAN D A , ALHARGANEE A , ALWAN A F, NAJI A S, SALEH T A, ALHACHMI A S , SHEMMARI I K A (Hematology/Oncology Dep, Al- Hussein Medical City, Karbala, Iraq, Email: dr_harganee@yahoo.com) : Hyper-CVAD protocol versus UKALL protocol and the minimal residual disease status in adult acute lymphoblastic leukemia patients. Int J Med Res Health Sci 2020, 9(10), 32-8.

In Iraq acute lymphoblastic leukemia (ALL) represents the most common hematological malignancy contributing 41 % of all leukemia cases. Hyper-CVAD protocol and UKALL protocol are commonly used in ALL treatment. In this study, we tried to assess minimal residual disease (MRD) post induction therapy for both hyperCVAD protocol and UKALL protocol by using 8 colors flow cytometry. Data collected retrospectively from 85 adult patients with acute lymphoblastic leukemia (≥ 14 years old) received either hyper-CVAD or UKALL chemotherapy protocol, with MRD level results post induction therapy of each protocol therapy, from January 2017 till October 2019. Fifty patients (58.82 %) with B-ALL, while T-ALL were 35 patients (41.18 %). Patients treated with hyper-CVAD protocol were 52 patients (61.18 %) while 33 patients (38.82 %) were treated with UKALL protocol. Patients with de novo ALL of Philadelphia chromosome negative, male to female ratio 2:1 and the mean age was 23 years. Thirty seven patients (43.53 %) achieved MRD negative. Of these MRD negative patients, 14 patients (37.84 %) were post UKALL while 23 patients (62.16 %) were post hyper-CVAD protocol with (p=0.9). Conclusion: Both hyper-CVAD and UKALL protocol therapy in adult ALL have a good efficacy without significant difference in achieving MRD negativity.

7 tables, 29 ref

044024   MADIREDDY S (Tanaka Drive, CA, USA, Email: samskruthi.madiireddy@gmail.com) : A winning combination among polyphenols, probiotics, vitamins for improved memory and cognitive performance. Int J Med Res Health Sci 2020, 9(10), 27-31.

Intake of polyphenols, probiotics, and multivitamins has shown beneficial effects on spatial memory, learning, and cognition. However, the effect of various combinations of these nutrients as dietary intake on cognitive performance has remained unexamined. Knowing which antioxidant combination would be most effective is important, especially because regular intake of all nutraceuticals may not be possible. This study examined the best combination of nutrients that enhances spatial memory and cognitive performance. Since quality of nutrition can have a significant effect on memory and learning, the outcome of this study could be significant to improving cognitive function in humans, particularly in the context of childhood education. Especially with current disparities leading to food deserts and differing access to quality food, this may reveal changes to make in mass nutrition to better support cognitive performance and learning.

2 illus, 1 table, 18 ref

044023   ALENZI F , ALENEZI H, ALSALEM W, ALADWANI M, ALMADANI A, ABOWADAAN M (Clinical Sciences Dep, Princess Nourah bint Abdulrahman Univ, Riyadh, Saudi Arabia, Email: fmalenzi@pnu.edu.sa) : The impact of knowledge, attitude of health sciences college students towards lifestyle modifications during clinical training in Saudi Arabia. Int J Med Res Health Sci 2020, 9(10), 22-6.

Unhealthy lifestyle lead to several comorbidities, although the health colleges students have greater awareness about the healthy lifestyle compared to non-health science students. However, the awareness does not mean that they are practicing healthy habits and diet in their life. moreover, the health college students experience more stress thus they have unhealthy diet and less physical activity, therefore they are going to fail in implementing the health education awareness for their patients as future health care providers. A cross-sectional study among health colleges in their clinical training years in different universities in Saudi Arabia to evaluate the impact of knowledge, Attitude of health college students towards lifestyle modifications during clinical Training. Overall response rate was 100 % (1005/500) 79 % were females. The smoking rate among the preclinical students (23.0 %) was higher than the clinical students (18.7 %) with nursing colleges ranked the highest (26.4 %). The prevalence of physically active students was 43.2 % in preclinical and 48.2 % in clinical students (p=0.04). Additionally, performing routine checkup among the preclinical students was (29.1 %) opposite to clinical students (38.4 %) (p=0.019). Conclusion: The main finding in our study shows that Clinical students generally improved their behavior more than preclinical students.

2 tables, 7 ref

044022   QATABERI H A, AHMED I M , ALRIFAIE H F, ALBRAHIMI D, SOMALY H A, ALMANSOURI F, WALI M, BARABEA D, MANSOOR A, HARAKA S (Oral and Maxillofacial Surgery Dep, AlFarabi Coll, Jeddah, Saudi Arabia, Email: iffatahmd.oms@fpc.edu.sa) : Prevalence and severity of plaque-induced gingivitis among saudi adult population in jeddah region. Int J Med Res Health Sci 2020, 9(10), 15-21.

To evaluate the prevalence and severity of plaque-induced Gingival inflammation (GI) among Saudi adult population in Jeddah region. One hundred and ninety-seven eligible participants in this cross-sectional study were recruited from routine dental patients attending the Oral Diagnosis Clinic at AlFarabi College in Jeddah, Saudi Arabia from Nov 2019 to May 2020. A clinical examination was performed by 2 dentists to measure the gingival and plaque indices of Loe and Silness for each participant. The prevalence of gingivitis was 100% among adult subjects aged between 20-50 years old. Moreover, both the male and female groups with generalized Gingival inflammation (GI) had significantly higher mean scores of plaque index. In addition, females with generalized GI showed a significantly higher plaque index % compared to males (p<0.05). Bleeding on probing (BOP) of generalized GI was higher in females than males. In fact a significant and positive correlation was observed between plaque index % and BOP % in both male and female localized GI groups. This shows that the plaque index and BOP are dependent on each other. However, females were more affected with localized gingivitis than males (p=0.0001). The results of this study show that plaque accumulation is strongly associated with high prevalence of generalized and localized gingivitis among Saudi subjects.

2 illus, 6 tables, 29 ref

044021   MOHIELDEIN A H (Medical Laboratories Dep, Qassim Univ, Buraidah, Saudi Arabia, Email: mabdelmarauf@hotmail.com) : Association between obesity and sleep duration in young adult saudis: A cross-sectional study. Int J Med Res Health Sci 2020, 9(10), 8-14.

The study aimed to assess the relationship between nightly sleep duration and obesity in young adult Saudi citizens. A cross-sectional study in which eighty-one healthy young adults were enrolled. Self-reported sleep duration per night was recorded from each participant. Sleep hours were categorized into three groups: normal (7-8 h), short (≤ 6 h), and long (>8 h). Weight, height, and waist circumference were measured for all participants. Body mass index was computed and WHO guidelines was used to estimate obesity. Venous blood samples were collected at fasting and 2-h after breakfast. Blood glucose and glycated hemoglobin were assayed by standard laboratory procedures. SPSS was used to analyze data. 69.6 % of overweight/obese subjects reported sleeping less than 6 hours per night while 37.1 % of normal weight subject did (p=0.008). 66.7 % of all participants spent over three hours per day in front of screen i.e. spent watching TV, using computer, playing video games. Data analysis revealed an inverse significant correlation between duration of sleep per night and body mass index (r=-0.246, p=0.027). Our findings collectively highlight the importance of having an adequate amount of sleep per night (7-8 hours) which could help in minimizing the epidemic of obesity and its associated co-morbidities. We should encourage young adults to create a positive behavioral change and improve their lifestyle choices by changing their delay in the timing of sleep onset.

3 tables, 30 ref

044020   ALSAIGH S H , ALRUWAILI K R, ALSALEH L I, ALGHADONI M A (Qassim Univ, Buraidah, Saudi Arabia, Email: 351204517@qu.edu.sa) : Hospital readmission after surgery: Rate and predisposing factors. Int J Med Res Health Sci 2020, 9(10), 1-7.

Readmission after surgery has become an important topic. Several studies have addressed this issue in different ways. One study assessed the risk factors of readmission 30 days after general surgery and found that many factors can result in readmission and postoperative complications. In this retrospective study, we reviewed the medical records of 13,800 patients who underwent surgery between 1/1/2016 and 31/3/2019 at King Fahad Specialist Hospital in Buraidah and documented the operative report, course of admission, and post-discharge records. A total of 46 patients were readmitted (readmission rate, 0.33 %). The mean age and body mass index did not differ significantly between the planned readmission and unplanned readmission cases (p=0.050). Sex was not associated with readmission type (planned vs. unplanned). The American Society of Anesthesiologists (ASA) grades for readmitted cases were as follows: ASA 1 (37.0 %), ASA 2 (47.8 %), ASA 3 (10.9 %), and ASA 4 (4.3 %). The most common cause for readmission was completion of management plan (n=14 30.4 %). The majority of patients were readmitted after 1 month (69.6 %). Only a few (6.5 %) patients were readmitted within the first week. Readmissions after surgical procedures have multifactorial risk factors; however, postoperative complications appear to be among the most common causes of readmission in surgical patients. Taking appropriate steps to decrease postoperative complications will help minimize postoperative readmissions, and a better understanding of the causes of readmissions after surgery will allow hospitals to develop programs to decrease their rates.

6 tables, 17 ref

044019   RUMYYAN A A, ALISSA H , ALKURAIDIS H , SAGER M , ALRAFFA S , ALHUMUD I , ALKHODAIR A, ALORAINI A , ALMUSTAFA N, ALGHAMDI J (King Saud bin Abdulaziz Univ for Health Sciences, Riyadh. Saudi Arabia, Email: Alkhodair.a@hotmail.com) : The prevalence of endodontic instrument separation among dental practitioners and dental students in Riyadh, Saudi Arabia: A crosssectional study. Int J Med Res Health Sci 2020, 9(9), 49-54.

This study aimed to investigate the prevalence of instrument separation and its management in Riyadh city. A survey was distributed in hard and soft copy forms. Target subjects were Undergraduate students, Dental interns, General practitioners, Postgraduates Endodontic, advanced general dentistry (AGD), Saudi board advanced restorative dentistry (SBARD), and Endodontists. The questionnaire contained three domains: demographic data, incidence of instrument separation, management and follow up of instruments separation. Data were statistically analysed, and the significance level was set at p<0.05. The study includes 455 subjects. Determined percentage of instrument separation with hand file was 56.1 % rotary file was 43.9 %, Nickel Titanium alloy was 49.8% and Stainless-steel was 50.2 %. Comparable percentage of instruments separation in molars was more than other teeth (52.4 %). The prevalence of instrument separation during root canal treatment was very high. Students and dentist awareness regarding causes and management of instrument separation should be increased to ensure successful root canal treatment.

2 illus, 1 table, 29 ref

044018   HAMMADI W A, HAMMADI H A, EL-SHEREEF E A A (Taif Univ, Kingdom of Saudi Aarabia, Email: wateenaah@gmail.com) : Study of future specialty career choice among female medical students in medical college, Taif University, Saudi Arabia. Int J Med Res Health Sci 2020, 9(9), 40-8.

Specialty career choice is an important decision for medical students. For most, this choice is an ongoing process throughout their undergraduate schooling. The aim of the study is to identify reasons for studying medicine, the future specialty choices by medical students, identify different influencing factors in students’ decisionmaking regarding future specialty interests. We conducted a survey on First and sixth-year female students at Medical College in Taif University during academic year 2018-2019, using a questionnaire probing about their specialty preference and reasons of their choice. The first choice of specialty was internal medicine specialty for first and sixth year students. The other prevalent choices were surgical specialty, ophthalmology, obstetrics and gynecology, then family medicine practice, pediatrics and dermatology for first and sixth year students choices altogether. Logistic regression analysis of reasons of choice of specialties showed that the first three statistically significant factors between first and sixth year students were: Interest in the clinical work of the specialty, Job availability and encounter with role model teachers. More than half of students mentioned that it is would rather avoided and will never work in remote and rural areas. Only (15.3 %) expressed willingness to practice medicine in remote areas with no significant difference between first and sixth year students. Main reason of choice of practice location was career development and being in hometown. Majority of students planned to specialize in well-known clinical areas. First year students favored medical practice specialties and sixth year students preferred surgical.

7 tables, 20 ref

044017   SHEAR F E (King Khaled Univ Hospital, Riyadh, Saudi Arabia, Email: felshaer@ksu.edu.sa) : Depression in patients with heart failure: A review article. Int J Med Res Health Sci 2020, 9(9), 31-9.

The incidence of depression in patients with heart failure ranges from 21 % to 42 %. Depression is a growing independent risk factor for high mortality, re-hospitalization and deterioration of the quality of life. The advanced stage of heart failure along with the low ejection fraction and functional class has a direct correlation with the extent of depression. Medical professionals may measure depression by using the GESS I CAMP acronym (Guilt, Energy, Sleep, Suicide Interest, Concentration, Appetite, Mood, Psychomotor) as a helpful method of evaluation, or either of a variety of readily administered and graded self-report questionnaires. Cognitive behavioral counseling explores the associations with the environment, physiology, attitudes, emotions, and how these may be changed to yield changes in behavior and mood. The STEPS acronym can be helpful: Safety, Tolerability, Efficacy, Payment, and Simplicity). Pharmaceutically, selective serotonin re-uptake inhibitors are endorsed, although tricyclic antidepressants are not prescribed in patients with heart failure. The use of a potent serotonin re-uptake inhibitor and cognitive behavioral treatment is also helpful when used together

52 ref

044016   AWWAD W , MUMTAZ R, ALSULTAN O , ALJURAYYAN A , AWWAD A , ALDAWSARI K , ALMAAWI A, ALSALEH K (Orthopaedic Surgery Dep, King Saud Univ, Riyadh, Saudi Arabia, Email: dr.rohail@gmail.com) : Unchanged patient attitude toward spine surgery despite about two decades of practice at tertiary care hospital. Int J Med Res Health Sci 2020, 9(9), 25-30.

Spine surgery carries a risk for the potential complications similar to any other surgical intervention. Our aim in this study to evaluate the patient attitude regarding spine surgeries and to understand the factors that could affect patient choice. A cross sectional study of 164 patients who visited King Saud University Medical City (KSUMC) outpatient spine clinic between January to October 2019 and had a surgical pathology. Each patient and his family were counseled regarding the need of the spine surgery and the possible complications. A general demographic questionnaire was used to assess patient response toward surgery and to identify the factors which might influence his decision. A total of 164 patients were included in this study. Ninety-eight were females and sixty-six were males. Sixty-five (39.6 %), agreed to surgery. The remaining ninety-nine (60.4 %) didn’t opt surgery for different reasons. Despite that the spine surgery is as safe as any other surgical intervention patients tend to refuse it. We strongly believe that patient education is very important change this negative attitude. Patient’s understanding about the disease if left untreated or inappropriately treated may play a crucial role to make a better decision.

3 illus, 1 table, 27 ref

044015   DAAJANI M M A , GOSADI I M , MILAAT W A, DAAJANI S M A , OSMAN A A, MOHAMMED S A (Health Education and Promotion Dep, Umm Al-Qura Univ, Kingdom of Saudi Arabia, Email: aaosman@uqu.edu.sa) : Barriers to and facilitators of antenatal care service use at primary health care centers in Jeddah, Saudi Arabia: A cross-sectional study. Int J Med Res Health Sci 2020, 9(9), 17-24.

This study aimed to identify the barriers to and facilitators of antenatal care service use in primary health care centers in Saudi Arabia. A cross-sectional hospital-based study was conducted. Participants were 239 women (mean age: 30.43 years; standard deviation: 5.49) who had recently delivered. Participants were divided into two groups: Group 1 comprised 80 women with inadequate antenatal care visits and Group 2 comprised 159 women with adequate visits. A structured questionnaire was used to compare barriers and facilitators impacting ANC visit adequacy. Women with inadequate visits experienced more structural and personal barriers than women with adequate visits. The total scores for the structural barriers were 56.3 % versus 25.8 % (p<0.001) whereas the total scores for personal barriers were 75 % versus 35.8 % (p<0.001). The most prevalent structural barriers for both groups were inconvenient clinic hours (31.3 % versus 21.4 %; p=0.112) and dissatisfaction with previous care (23.8 % versus 10.1 %; p=0.007). The most prevalent personal barriers were fear of examination and medical tests (26.3 % versus 14.5 %; p=0.034) and transportation problems (33.8 % versus 7.5 %; p<0.001). The most frequently mentioned facilitator was effective staff communication (80.2 %). Several barriers are associated with antenatal care service use. This study contributed to identifying these factors to improve clinical practice. Efforts should be made to arrange convenient clinic hours, reduce waiting times and easily secure appointments, provide transportation, decrease patient fear of examinations and medical tests and patient stress, and increase patient knowledge about existing services and supports.

4 tables, 24 ref

044014   AHMED I M, ALSHEHRI R A, ALBALAAWI R N, BENDAGJI R A, KHALAF S M , KHALID S, REDWAN M S (Oral and Maxillofacial Surgery Dep, AlFarabi Coll, Jeddah, Saudi Arabia, Email: iffatahmd@gmail.com) : Clinical difficulties among left handed dentists, dental students and interns-a cross-sectional survey in Saudi Arabia. Int J Med Res Health Sci 2020, 9(9), 9-16.

The practice of dentistry largely depends on manual dexterity and hand skills. Appropriate position and equipment according to the dominant hand is very important for safe and effective dental practice. Most of the dental chairs used in training or dental practice are designed to be used by right handed dentists. The aim of the study was to assess whether left-handed (LH) dental students and dentists faced any problems during their course of study or in dental practice and their perspectives based on their discomfort. A questionnaire was used the survey tool to conduct a cross-sectional survey among LH dental students, interns and dentists. A total of 152 LH dentists and dental students completed the survey. 52.6 % of the participants reported sometimes having a problem in being LH to do the required dental work. 31.6 % of the participants reported having a problem with RH instructors. Only 20.4 % reported they can easily use devices manufactured to be used by RH dentists. 77 % reported that patients complained of their working from the left side of the dental chair. The findings of this study support a need for alterations to learning environment and personalized teaching to better support LH students in their learning experience to avoid difficulties faced by them and to provide adequate working environment for LH dentists.

1 illus, 4 tables, 14 ref

044013   BEGUM A, KASHIF S , AMBREEN S, KHAN L (Radiology Dep, Wah Medical Coll, Wah Cantonment, Pakistan, Email: aeishasalman@gmail.com) : Neonatal sonographic hip screening for developmental dysplasia of hips. Int J Med Res Health Sci 2020, 9(9), 1-8.

Ultrasound screening is recommended for newborn babies in many countries to rule out Developmental dysplasia of hip (DDH) as it is more sensitive and specific compared to clinical examination. The purpose of this study was to perform a preliminary assessment of neonatal hips in our region and highlight the magnitude of DDH as there is lack of local literature on this subject. We evaluated 132 hips newborns referred to our department using Graf static method of alpha and beta angle measurement and classification. The data collected was statistically correlated. Mean age was 1.5 days. There was no statistically significant difference between the mean alpha and beta angles of right and left side of hips or between male and female babies. The predominant hip type in both genders and on both sides was Graf Ia (75 % of right and 69.9 % left sided hips) followed by IIa. Although the vast majority of babies had normal or physiologically immature hips, a small number of children had abnormal hips requiring treatment. In order to diagnose the highest possible number of cases, we recommend further large scale studies targeting our population on the basis of which universal or selective screening programs for a wider clinical application could be based.

2 illus, 6 tables, 23 ref

044012   ALREEFI M, ALAHMED S, ELYAHYA F , KHOSHAIM A, HJJI F, ALHOMAIDAN F (King Saud bin Abdulaziz Univ for Health Sciences, Kingdom of Saudi Arabia, Email: Fahad_zy@outlook.com) : Assessing the need of an integrated research assistance program towards aiding students in the progress of medical research during undergraduate studies, Riyadh, Saudi Arabia. Int J Med Res Health Sci 2020, 9(8), 43-9.

To assess the need of medical students for a research assistance program. This study was conducted at a medical college in Riyadh, Saudi Arabia. A cross-sectional study was conducted utilizing an online questionnaire consisting of three parts: student demographics, students’ research proficiency, and problems faced when conducting research. Data from the collected information was analyzed and all values of p<0.05, 95 % confidence intervals for odds ratio that did not cross 1.00 were considered to indicate statistical significance. Students who participated in this study were 228 (response rate=57 %). 60.5% (n=138) were male, and 28 % (n=64) were in their first year of medicine. The majority were working on at least one to two researches, 81.1 % (n=185), with 5.3 % (n=12) having a study published. 83 % of participants reported to be skillful at data collection and data entry. Devising a research idea was measures most difficult (49 %). More female students were able to write a research proposal (n=57; 63.3 %. p=0.022), and seniors were more capable in research than freshmen (p<0.001). Results demonstrated that students are active and well acquainted with research activities; 81.1 % (n=185). In order to enhance research performance, we recommend offering the opportunity to share efforts with senior students or professionals to be appraised, be provided with information regarding supervisors’ research interests, and creating online platforms for improved knowledge transfer and communication between the parties involved.

3 tables, 10 ref

044011   FATHULDEEN A A , KHAN F H , ALJADANI A H, ALMANSOUR D N , ALSHAMMARI A M , ALSHAMMARI M N, ALSALEH O S (Psychiatry Dep, Hail Univ, Saudi Arabia, Email: dr.a.aljadani@gmail.com) : Awareness of first aid in different burn degrees and its surgical and psychiatric aspects on patients, in hail, Kingdom of Saudi Arabia. Int J Med Res Health Sci 2020, 9(8), 33-42.

Burn injuries are one of the most traumatizing and damaging wounds. Causing considerable mortality, prolonged hospitalization, disfigurement, disability, often with resulting social stigma, rejection, psychiatric issues in long run. We aimed to assess the knowledge of general population on first aid and surgical intervention in different degrees of burns and psychiatric aspect on patients; so, the results of this study could help to manage burn injuries. A descriptive cross-sectional community-based survey was conducted in shopping malls of Hail KSA. Data was collected from the audience who attended Health Awareness Campaign on Burns between 15th of December 2019 and 15th of January 2020. Data was fed and analysed by using SPSS version 23. Forty-seven percent of the respondents have received information on burns. Half of respondents had history of either oneself being affected by burn incident or any one of their close relatives. Out of 273 burn cases, 65 had complications later. Almost 29% developed psychiatric issues after that incidence but just 8 % consulted Psychiatrist. Only 2 % were familiar with the surgical aspect for healing of second-degree burn. Knowledge of respondents on the burn’s issues is very scanty as revealed in our results. 15 %-24 % of respondents did not know what to do in 1-3 degree of burns that is very alarming. Just 16 % knew that there is any role of plastic surgery in 3^rd degree burns. Twenty-nine percent had suffered from psychiatric problems after burn incident but just 8% consulted any Psychiatric and those were ones who had total monthly income ≥ 10,000 Saudi Riyals (p ≤ 0.05). These results emphasize the importance of implementing Health Awareness Campaigns in community and in institutions that could minimize burn incidents and psychiatric issues in general population.

1 illus, 6 tables, 35 ref

044010   IZZATOV A, BARENGOLTS E (Tyan Anmo Medical Massage School, Illinois, USA, Email: aybekizzatov@yahoo.com) : Effectiveness of manual physical therapy and NSAIDs as a combination therapy in arthritis patient-a case series. Int J Med Res Health Sci 2020, 9(8), 25-32.

Among various types of arthritis Osteoarthritis (OA), Psoriatic arthritis (PA) and Gouty arthritis (GA) are the major ones which have been studied and cause hindrance in movements in many patients. Here we have discussed the treatment modality, a combination of manual therapy and NSAIDs (Ibuprofen) for relieving the symptoms of arthritis. A total of six patients were included consisting of osteoarthritis, psoriatic arthritis and gouty arthritis who presented at the medical office of Dr. Barengolts (MD in USA) and Aybek Izzatov (MD in Uzbekistan) Tyan Anmo Massage School. The study was conducted from October 2019 to March 2020. The treatment consisted of 30 sessions performed for half a year, one week per month (5 days in a month). Significant improvement in symptoms was seen as after 6 months we saw there was reduction in morning stiffness and improved range of motion. The pain score shifted from 5-6 to 2-3 on VAS pain scale. The results signify that the combination therapy wherein manual therapy and NSAIDs worked in an effective way to reduce the level of severity of pain and other associated symptoms.

51 ref

044009   HEGDE P, SHETTY V, RAI A, BADRINATH S (Oral and Maxillofacial Surgery Dep, Deemed to be Univ, Mangalore, Email: drsaiswarupb@gmail.com) : Platelet rich fibrin and its relevance in oral and maxillofacial surgery. Int J Med Res Health Sci 2020, 9(8), 20-4.

Platelets have a major role to play in cessation of bleeding and hemostasis and the studies in the recent past have led to a better understanding in identifying their functions in regulation of immune response, wound healing, osteogenesis, and angiogenesis and is a subject of great interest. It has been proved that plalelets play a crucial role in the formation of blood clot and release growth factors, thereby promoting and maintaining the process of wound healing. Platelet rich fibrin (PRF) is product derived of platelets from one’s blood and when used either in its gel or liquid form, it enhances tissue repair. In the recent past, the PRF has been used extensively in various oral and maxillofacial surgical procedures successfully. We conducted a narrative review over the literature using electronic databases as; PUBMED, SCOPUS, Google Scholar studies involving data on platelet rich fibrin and its application in Oral and Maxillofacial Surgery. We reviewed the reference lists of included studies to find more relevant articles for additional evidence. It has been observed that PRF enhances the recovery and contributes to the post-operative healing and general well-being.

27 ref

044008   ROSLI T I, TING K B Y , MEI L H , XIN L R , ASHAR N A, YEO S S (Kebangsaan Malaysia Univ, Kuala Lumpur, Malaysia, Email: tantiir@ukm.edu.my) : Dentition and risk of malnutrition among elderly patients in faculty of dentistry, universiti kebangsaan Malaysia, Malaysia: A cross-sectional study. Int J Med Res Health Sci 2020, 9(8), 13-9.

To assess the dentition status and its association with the risk of malnutrition among a group of elderly patients in Kuala Lumpur A cross-sectional study was conducted among elderly patients who attended dental clinics in the Faculty of Dentistry, Universiti Kebangsaan Malaysia (UKM). Data on oral health conditions namely the number of teeth, number of posterior occluding pairs, and denture status were gathered from patients’ dental records. The nutritional status of respondents was determined using the Malay version of Mini Nutritional Assessment (MNA) followed by Body Mass Index (BMI) measurement. Statistical analysis included descriptive analysis, Chi-square test of association, and correlation coefficient test. Total tooth loss (edentulous) was seen in 31 (28.4 %) patients from a total of 109 respondents. From those who still had natural teeth, 65.4 % had less than 20 teeth. Based on the MNA score, only 1.8 % were malnourished. The majority of them (78.9 %) had normal nutritional status while 19.3 % were at risk of malnutrition. Patients with lower education levels showed significantly lower mean MNA score and number of teeth. No significant association was noted between MNA scores and the number of teeth present. A slightly higher percentage of patients with less than 20 teeth (22.0 %) were at risk of malnutrition and malnourished compared to those with more than 20 teeth (12.0 %) but no significant association was observed (p>0.05). There was no significant association observed between the number of teeth and the risk of malnutrition among patients undergoing dental treatment in UKM.

4 tables, 20 ref

044007   FATIMA R , BAIG M T, ARSALAN A , SHAHID U , JABEEN A , ALI M M , SHAHNAZ S , SHAIKH S , MIRZA A S, KHAN S A (Pharmacy Practice Dep, Ziauddin Univ, Karachi, Pakistan, Email: mirzatasawerbaig@gmail.com) : Irrational use of quinolones in tertiary care hospital Karachi, Pakistan. Int J Med Res Health Sci 2020, 9(8), 9-12.

The antimicrobial drugs especially Quinolones are the top most therapeutics class of drug prescribed in some country like Pakistan in primary and tertiary care hospitals and clinics. The objective of the study was to assess the irrational prescribing practice of quinolones in tertiary care setups of Karachi. A prospective observational study was conducted for the period of 04 months from November 2019-February 2020, in Public and Private Sector Tertiary Care setups of Karachi. Data was collected from surgical, medical and emergency wards on the basis of World Health Organization prescribing pattern, to evaluate the prescriptions based on Culture sensitivity tests (CST), empirical, targeted, and/or prophylactic therapies. Out of total 1000 patients 41.6 % patients were from Public and 58.4 % were from Private Sector Tertiary Care Hospital. 13.7 % of the patients from Public and 24.8 % from Private Sector Tertiary Hospitals were prescribed Quinolones after performing their Culture Sensitivity Test. However, 79.8 % of the patients were prescribed Quinolones without Culture Sensitivity Test. 36.4 % patients were prescribed with empirical therapy, 20.2% with De-Escalation therapy, while 43.4 % were prescribed with prophylactic therapy of quinolones. Study concluded that some serious efforts are required to avoid the irrational prescribing practice and promote the rational prescribing practice of antibiotics particularly for Quinolones.

3 tables, 17 ref

044006   HASSOUNI K EL, REFIKER H (Near East Univ, Nicosa, North Cyprus Mersin 10, Turkey, Email: hurmus.refiker@neu.edu.tr) : A pilot study: Consumptions of statins in morocco and North Cyprus. Int J Med Res Health Sci 2020, 9(8), 1-8.

Cholesterol lowering drugs, statins, are a major and dominant group of hypolipidemics and are often prescribed in clinical practice for the prevention and treatment of cardiovascular diseases. To assess the consumption of statins, more specifically rosuvastatin, atorvastatin and simvastatin in two different countries; Morocco and North Cyprus. The study was conducted in Pharmacy Kounouz, Rabat, Morocco and Pharmacy Umut ÖKSÜZ in Nicosia North Cyprus. During the period of November, December 2018 and January 2019. This study involves a sample of 100 patients of pharmacy Kounouz, Rabat Morocco and Pharmacy Umut ÖKSÜZ, Nicosia, North Cyprus, who were on regular therapy with statins (Atorvastatin, Simvastatin or Rosuvastatin) in the mentioned period. The difference in the frequency distribution of gender in the sample was visible in both countries where males represent a larger part of patients under statins treatment. Presence of remarkable difference between the consumption of atorvastatin, simvastatin and rosuvastatin in both countries. The most common prescribed statin dose was 10 mg in North Cyprus, while in Morocco the most common dose was 20 mg. In this sample of patients, considering the prescribed doses in relation to gender, the female patients are prescribed somewhat lower doses of statins than male patients. While in North Cyprus, the most frequently prescribed drug was atorvastatin, in Morocco, rosuvastatin was most frequently prescribed statin.

7 illus, 1 table, 24 ref

044005   NALINKUMAR A, SINGH P (Nutrition and Dietetics Dep, Manav Rachna International Institute of Research and Studies, Haryana, Email: aneesha 0316@gmail.com) : An overview of buckwheat (Fagopyrum spp)-an underutilized crop in india-nutritional value and health benefits. Int J Med Res Health Sci 2020, 9(7), 39-44.

Buckwheat is one of the pseudocereals grown annually in hilly regions of India. It belongs to the family Polygonaceae and genus (Fagopyrum spp.) Buckwheat is adaptable to extreme cold temperatures, stress conditions of water, less soil fertility and varying climatic conditions, making it a sustainable crop. A literature search on Buckwheat was done using PubMed and Google search engines and reviewed to prepare an overview of its cultivation, nutritional and health value. In India, twenty species of Buckwheat are cultivated across various hilly regions. Out of these only nine species have desirable nutritional value and two are commonly grown. They are Fagopyrum esculentum Moench (Common buckwheat) and Fagopyrum tataricum (Tartary buckwheat). However, the cultivation of Buckwheat has declined in the 20^th century making it an underutilized crop. Buckwheat has good amount of nutrients and many health benefits. There is a need to research about this under-utilized crop and create awareness as this crop has many nutritional and health benefits.

1 table, 36 ref

044004   AMBIKE M, CHOPADE D (Symbiosis International (Deemed) Univ, Lavale, Pune, Email: mandar.ambike@smcw.siu.edu.in) : Prevalence of thyroid dysfunction in down’s syndrome. Int J Med Res Health Sci 2020, 9(7), 32-7.

Association of Down’s syndrome and Hypothyroidism is reported since long time. It is difficult to diagnose Hypothyroidism in Down’s syndrome as the symptoms overlap. Different studies reveal different views regarding the association. So in present study we tried to find out the association between Down’ syndrome and Hypothyroidism. Methodology: Present study was conducted at “Down Syndrome care association, Nashik, India”. The study group was 68 known cases of Down’s syndrome. TSH levels were obtained from blood sample at the earliest. Data was analysed statistically. Results: Overall population had 36 % cases had high TSH levels. High TSH level in children below 5 years is 24 %. The high level of TSH in children of the age group 5 years to 10 years is 46 %. And percentage of children above the age of 10 years with high TSH level is 83.34 %. Conclusion: Percentage of thyroid dysfunction is defiantly higher in children’s suffering from Down’ syndrome than normal population. Percentage goes higher as the age increases, so periodic check-up of thyroid function is recommendeds.

5 illus, 5 tables, 28 ref

044003   ABOALELA A, ALSHAFEI A, ALMOUSA M A , ALHARBI G K , ALQAHTANI A S, SHRAIM N M B (Ministry of the National Guard -Health Affairs, Riyadh, Saudi Arabia, Email: aboalelae@ngha.med.sa) : Knowledge and awareness of COVID-19 among dental students, interns, clinicians and academics. Int J Med Res Health Sci 2020, 9(7), 25-31.

COVID-19 is a highly infectious disease caused by an RNA virus belonging to a large family of coronaviruses. WHO declared COVID-19 as a public health emergency and classified it as a pandemic. Aim: The study aims to evaluate and assess knowledge with regards to COVID-19 among dental students, interns, clinicians and academics in Riyadh, Saudi Arabia. A cross-sectional study was conducted among 366 dental students, interns, joint academic appointee, and full-time faculty. Data was collected using an electronic based questionnaire distributed through E-mails. Data was entered and analyzed using SPSS Version 23 with a significance value of p<0.05. Chi-square test was used to compare categorical variables. Almost all participants acquire adequate level of knowledge regarding the mode of transmission, incubation period and symptoms of COVID-19. Approximately half of the participants 205 (56 %) thought that standard precautions in the dental clinics were insufficient in the management of suspected cases of COVID-19. Nearly all participants thought that elective dental treatment should be deferred, and only emergency treatment can be provided. However, there was a poor response regarding the correct survival duration of COVID-19 on plastic or stainless-steel surfaces and the use of pre-operational hydrogen peroxide mouth rinse as a method of preventing transmission. This study identified areas where participants lacked the knowledge in managing COVID-19 with the best methods available especially at an undergraduate level. In order to have a more efficient and appropriate response for future pandemics, dental curriculums and educational activities should pro-actively provide training opportunities.

1 illus, 5 tables, 12 ref

044002   ALQAHTANI R A , ALZAHRANI M Y , QANDIL A M, ALKATHERI A A, SHAWAQFEH M S, ALBEKAIRY A M (King Saud Bin Abdulaziz Univ for Health Sciences, Riyadh, Saudi Arabia, Email: bekairya@ngha.med.sa) : Knowledge and attitude towards board of pharmacy specialties (BPS) certification among pharmacists and pharmacy students: A cross sectional survey. Int J Med Res Health Sci 2020, 9(7), 18-24.

For decades, the American Board of Pharmacy Specialties (BPS) has provided specialty certification programs for pharmacists. As pharmacists become involved in more advanced patient care services, board certification becomes an essential component to ensuring quality care. The aim of this study was to measure the self-reported knowledge and attitude towards the BPS certification. A cross sectional study included all pharmacy students and pharmacists at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) and King Abdulaziz Medical City (KAMC), respectively. However, the administrative pharmacy staff was not included. This is a manually distributed survey was adopted from previous published observational study. The survey included 6 demographic, 12 knowledge and 15 attitude questions where the participant rank from 1 to 5 (1: very poor, 2: poor, 3: Average, 4: good and 5: very good). This study is approved by IRB. Descriptive statistics were primarily used to analyze data. Categorical responses were compared using Chi-square tests. In total of 221 participants agreed to participate in the study based on convenient sampling, there were more female participants (134, 60.6 %) than male (87, 39.4 %). More number of participants (191, 86.4 %) were under the age-group ≤ 30 years. The overall mean age was found to be 25.20 ± 5.86 (20-60) years. Among 221 participants, 118 (53.4 %) were students and 103 (46.6 %) were employees. The current study found that 55.2 % of respondents have a good knowledge about BPS certification. However, only 48.4 % of participants reported their interest in pursuing board certification in their future career. Many respondents were aware of BPS certification, learning the most through didactic and experiential activities, and many indicated they are considering pursuing BPS certification. College of pharmacy and professional organizations can help provide educational session regarding board certification and professional development opportunities.

3 tables, 21 ref

044001   ALHOMAM H, ABDALLA M, ALTURKI A , QUTBALDEEN B , ALJAAWAN S , ALGHAFEES M, ALMODAIMEGH H (King Faisal Univ, AlAhsa, Saudi Arabia, Email: Hessah.mh@hotmail.com) : Efficacy of midodrine on hemodynamics. Int J Med Res Health Sci 2020, 9(7), 11-7.

To assess the use of Midodrine among patients with orthostatic hypotension and withdrawal vasopressin in King Abdulaziz Medical City (KAMC), demonstrate the effectiveness and safety of Midodrine and detect side effects to provide clear evidence of the efficacy and safety of the drug. A retrospective cohort study was done in King Abdulaziz Medical City in Riyadh (Saudi Arabia). The study targeted adult patients who suffered from hypotension between January 2015 and January 2018. The data was extracted using the BESTCare system. A total of 173 patients were included (55.5 % male and 44.5 % female). The mean age of the study participants was 67.34 ± 16.0 years. The differences in patients’ parameters before and after midodrine administration were detected and analyzed. The mean difference in hemoglobin (g/l) level was significantly changed before (94.97 ± 21.9) and after (90.84 ± 20.4) the use of Midodrine (p=0.031). However, there were no significant changes in the level of the other parameters before and after the use of Midodrine. The mean dose of Midodrine was 5.3 mg, with mean treatment duration of 41.5 days, and mean hospitalization of 28.7 days. For the medication history, 8 % of patients were on betablockers (n=97), 5 %were on diuretics (n=64), and 2 % were on calcium channel blockers (n=19). Our data suggest that the administration of Midodrine does not affect patients’ hemodynamics significantly; however, it has a notable effect on decreasing hemoglobin levels.

2 illus, 4 tables, 15 ref

044000   AL-GHAMDI H S, EL-HAWARY H M , ATTA I S, ALGHAMDI H A, AL-ZAHRANI R K (Internal Medicine Dep, Al Baha Univ, Kingdom of Saudi Arabia, Email: Dr.hasan33@hotmail.com) : Association between the academic stress level and skin disorders among albaha university medical students, Saudi Arabia. Int J Med Res Health Sci 2020, 9(7), 1-10.

Medical students are usually exposed to academic and social isolation in addition to environmental and financial stressors. There is a growing concern about an association between increased academic stress levels and several skin disorders. This paper aimed at assessing perceived stressors and their origins by examining the relationship between academic stress and skin disorders among medical students at the University of Albaha. A cross-sectional study consisting of 251 medical students from both the male and female sections was conducted. The participants received a self-administered questionnaire consisting of sociodemographic profile and origin of stressors, such as academic, psychosocial, and environmental stressors, and a Perceived Stress Scale (PSS) with a modified form of the self-reported skin disorders. Skin examinations were done via dermatological consultant at Albaha University Medical Centre. Academic stress, in comparison to other types of stressors, represents 80.5 % of the origin of stressors affecting stressed medical students. Being female in academic years above the third year was associated with the highest, most significantly perceived stress levels among all students. Loss of hair, pimples beside oily, waxy patches on scalp, itchy skin and troublesome sweating were the top common highly significant dermatological symptoms among all students at different levels of perceived stress. Several skin disorders occur in response to academic stress among medical students.

1 illus, 5 tables, 26 ref

042060   KARACAOGLU E, OZTURK E (Metallurgy and Materials Engineering Dep, Karamanoglu Mehmetbey Univ, Karaman, Turkey, Email: ekaracaoglu@kmu.edu.tr) : Photoluminescence properties of Eu³⁺ -activated Y_1.50Sc_0.50O₃ phosphors. Indian J Chem Sec A 2020, 59A(11), 1632-6.

In this research, Eu³⁺ activated and Dy³⁺-co-doped Y₂O₃ based phosphors have been synthesized by solid-state reaction method under open atmosphere. The host lattice is composed of 0.25 moles of Sc₂O₃ which is added to phosphor composition. Thus, Sc³⁺ substitution of Y³⁺ ions is implemented to form Y_1.40Sc_0.50O₃ host lattice. The thermal analysis (DTA/TG) have been carried out from 50 °C to 1400 °C for preliminary examination of thermal behavior of phosphors during heat treatments. After the heating process, the phase formations are characterized by X-ray diffraction resulted as Y₂O₃ single phase cubic structure. The effects of Eu³⁺ and Dy³⁺ dopant ions on the photoluminescence and phase formation properties of the hosts are investigated and determined as Dy³⁺-co-doped phoshor has the reduced excitation/emission intensities as well as decay lifetimes.

9 illus, 1 table, 11 ref

043999   HABIB R , AFTAB R R , SOHAIL H , JAVED R M M , CHAWLA S , KAMRAN R , IJAZ F, AFTAB R K (CMH Lahore Medical Coll, Lahore, Pakistan, Email: farhat_khurram_rana@cmh.edu.pk) : Association of central corneal thickness with age and serum electrolytes in hypertensive and non-hypertensive patients. Int J Med Res Health Sci 2020, 9(6), 85-92.

The normal Central corneal thickness (CCT) ranges about 510-520 microns. It is normally seen in clinical practice that corneas which are thicker are linked with greater intraocular pressures (IOPs). The purpose of the study was to determine the central corneal thickness and establish its relationship with age and serum electrolytes in hypertensive and non-hypertensive patients. A total of 108 subjects were included in our cross-sectional comparative study (54 hypertensive and 54 non-hypertensive). Written informed consent was taken. We measured blood pressure with mercuric sphygmomanometer. Ultrasound pachymeter was used to measure central corneal thickness while we drew 5 ml of blood for estimation of the serum electrolytes. Data was entered and evaluated using IBM SPSS 17. Quantitative variables were presented as Mean ± SD. Pearson correlation was used to find correlation of normally distributed variables p-value ≤ 0.05 was considered to be statistically significant. Central corneal thickness was statistically same in hypertensive and non-hypertensive subjects. Serum Na⁺ was significantly increased in hypertensive subjects while serum K⁺ and Cl^- were significantly decreased in hypertensive subjects. No significant correlation was seen in hypertensive while weak negative correlation was observed between CCT and age in non-hypertensive patients. Weak positive correlation was observed between CCT and Na⁺ both in hypertensive and non-hypertensive. Significant correlation was observed in CCT and K⁺ in hypertensive while negative correlation was seen in non-hypertensive. Weak correlation was observed in CCT and Cl^- both in hypertensive and non-hypertensive. Mean CCT was significantly lower in hypertension. CCT and age showed weak and positive correlation in hypertensive while weak and negative correlation in non-hypertensive. Serum electrolytes and CCT showed no significant correlation.

4 illus, 1 table, 43 ref

043998   GHAFOOR M B, IQBAL J , MUHAMMAD G , HUSSAIN M S , MUSTAFA G, SALEEM M ( Pathology Dep, Health Sciences Univ, Lahore, Pakistan, Email: drbilal.ryk@gmail.com) : Awareness regarding thalassemia in general population of rahim yar khan, Pakistan. Int J Med Res Health Sci 2020, 9(6), 79-84.

Thalassemia, an inherited blood disorder represents a significant burden for many countries across the globe and the knowledge related to this illness is very limited. The preventive practices, among people especially from developing countries. In Pakistan, Thalassemia is a serious health problem bearing 5 to 8% frequency of beta-Thalassemia gene without discrimination of ethnic groups. To assess the awareness level regarding Thalassemia in general population of Rahim Yar Khan, a district of Southern Punjab, Pakistan. Study Design: Cross sectional study. A total of 400 adults of 18 years and above age, were selected randomly, from the households of the Rahim Yar Khan City and one Rural Union council. Out of 400 subjects, only 131, reported that they had heard the name ”Thalassemia”, hence for analysis of awareness, the data of only these 131 was used. A structured questionnaire was designed which included information on; gender, age and 24 questions about awareness of Thalassemia disease. Level of Awareness was ascertained by response of these 24 questions and was categorized as poor, average and good. The persons answering less than 12 questions correctly were considered to have poor knowledge, answers of 13-18 questions were labeled as possessing average knowledge and the persons were included in category of having good knowledge who answered more than 18 questions correctly. Data was analyzed by using SPSS 20. Out of 131 study subjects , who reported to have ever heard of word Thalassemia, level of awareness about Thalassemia was found to be “Good” among 7 (5.4 %) persons, 27 (20.6 %) persons have an average knowledge about Thalassemia and a large number of people 97 (74 %) have poor knowledge about Thalassemia disease. Public knowledge regarding Thalassemia was found to be poor among general population of Rahim Yar Khan, Pakistan.

2 tables, 12 ref

043997   AHMED I A M (Anatomy Dep, Najran Univ, KSA, Email: itedalanatomy@gmail.com) : Role of multiple choice questions in assessment of competency of knowledge in anatomy. Int J Med Res Health Sci 2020, 9(6), 72-8.

The main objective of the current study is to examine the items using the item analysis to assess their competency of knowledge in human anatomy. This is a quantitative descriptive cross-sectional study conducted at the Najran University faculty of Medicine, in the department of anatomy. A 31-second year MBBS students of level three took the multiple-choice question exam comprising 100 questions in one session. Each item was analyzed by item analysis. The planned period of data collection is the first semester of the academic year 2019-2020. The data were analyzed using SPSS version 25, and Excel Software. All analyses were performed using the descriptive frequency, explore and correlation probabilities a p-value, p<0.01 (2-sided) was considered to indicate statistical significance. The assessment of test items use the item analysis that is very difficult question: 25; 25 %, difficult question: 8; 8 %, average question: 46; 46 %, easy questions; 9; 9 % and very easy: 9; 9 %. The discrimination indices, which are poor discrimination; 34; 34 %, acceptable discrimination; 11; 11 %,good discrimination; 6; 6 %, very good discrimination; 4; 4 % and excellent discrimination; 45; 45 %. The performance of students in this test showing that a large number of items have a role in distinguishing students knowledge in the anatomy test, but in Simple parts of the scale that the items did not succeed in assessing students. Items of anatomy exams displayed a strong relationship of difficulty (P) and discrimination (D) indices. The MCQs items assess their competency of knowledge in human anatomy. The competence of students in the knowledge of anatomy measured at a high rate of A-type context-rich MCQs can be stem is case scenario, lead-in; question and options; distractors, and key. These items can differentiate good and poor accomplishment students..

4 illus, 1 table, 20 ref

043996   ALHARBI S H, ALHARBI A O , MAHROUS A K , ALRESHIDI A H , ALSHAMARI J S , ALQUWAIAY D A , ALANAZI W S , ALGHAITHI A M , ALTORAIFI A S, AHMED H G (Histopathology and Cytology Dep, Khartoum Univ, Sudana, Email: hussaingad3@gmail.com) : Hemodynamic variations associated with ramadan fasting among saudi stroke’s patients. Int J Med Res Health Sci 2020, 9(6), 63-71.

It was reported that intermittent fasting has several health benefits. Therefore, the present study aimed to assess the hemodynamic variations associated with Ramadan fasting among Saudi Stroke patients. Methodology: Information referring to 61 stroke patients were retrospectively retrieved from King Khalid hospital, Hail, Northern Saudi Arabia. Data relating to patients attended during the period from April 2019 to June 2019. The sample involved two months (Shaban and Ramadan) a full coverage sample. Out of 61 study subjects, 26 patients were fasting during stroke happening and 35 patients were non-fasting. Out of the 61 patients, 35 (57.4 %) were females and 26 (42.6 %) were males. With the fasting month, hypertension was co-occurrence in 23/49 (47 %) fasting patients, hence, it occurred in 26/49 (53 %) among non-fasting patients, the risk of hypertension during Ramadan compared to nonfasting month; the relative risk (RR) and 95 % confidence interval (95 % CI): RR (95 %CI)=1.1908 (0.9374 to 1.5128). Ramadan Fasting has some beneficial effects influencing stroke including incidence and severity reduction. Stroke associated hemodynamic variants, which were more apparent among women, were perceived to decline during fasting.

4 illus, 6 tables, 19 ref

043995   ABBAS Q (AL Imam Muhammad Ibn Saud Islamic Univ, Riyadh, Saudi Arabia, Email: qaabbas@imamu.edu.sa) : DME-Deep: A computerize tool for detection of diabetic macular edema grading based on multilayer deep learning and transfer learning. Int J Med Res Health Sci 2020, 9(6), 54-62.

Diabetic macular edema (DME) is a common disease of diabetic retinopathy (DR). Due to the infection of DME disease, many patients’ vision is lost. To cure DME eye disease, early detection and treatment are very important and vital steps. To automatically diagnosis DEM disease, several studies were developed by detection of the macula center which is dependent on optic disc (OD) location. In this paper, a novel features pre-training based model was proposed based on dense convolutional neural network (DCNN) to diagnose DME related disease. As a result, a computerize tool “DME-Deep” for detection of DME-based grading system was implemented through a new dense deep learning model and feature’s transfer learning approaches. This DCNN model was developed by adding new five convolutional and one dropout layers to the network. The DME-Deep system was tested on three different datasets, which obtained from online sources. To train the DCNN model for features learning, the 1650 retinal fundus images were utilized from the Hamilton HEI-MED, ISBI 2018 IDRiD and MESSIDOR datasets. On datasets, the DME-Deep achieved 91.2 % of accuracy, 87.5 % of sensitivity and 94.4 % of specificity. Compare to obtain hand-crafted features, the automatic feature’ learning it provided favorable results. Hence, the experimental results also indicate that this DME-Deep system can automatically assist ophthalmologists in finding DEM eye-related disease.

3 illus, 2 tables, 22 ref